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PEDIATRIC PERSPECTIVE

Though widely used, corporal punishment is an unproven treatment for misbehavior

Today, many American children receive an ineffective, unproven therapy whose practitioners insist it improves school performance, enhances discipline, and leads to more ethical behavior. In reality, the treatment as practiced by most parents and teachers has no lasting benefit. Large studies repeatedly find problematic side effects -- particularly from high doses -- including criminal behavior and aggression.

The technical term for the therapy is ''corporal punishment," which includes a variety of methods such as spanking, whipping, and paddling to modify a child's behavior by causing pain but not lasting injury. Recently, the topic again got press when former actress Lisa Whelchel, who played Blair on television's ''The Facts of Life," appeared on Good Morning America to endorse ''hot-saucing" children's tongues (for example, with Tabasco) for lying or biting, saying ''I prefer my child receive a small amount of pain from my hand of love than to encounter a lot more pain in life."

Whelchel isn't alone in her logic. Almost 60 percent of pediatricians support corporal punishment in some form, and when the American Academy of Pediatrics issued its delayed policy arguing against corporal punishment in 1998, it did not call for a complete ban. According to a recent Gallup poll, 95 percent of parents hit their children at some point. In 1998, 55 percent of American parents agreed with the statement, ''A good hard spanking is sometimes necessary."

The respected Family Research Laboratory at the University of New Hampshire reports that about one-third of parents have hit an infant, and that most parents occasionally hit their 12-year-olds. About one-quarter of spankings to kids aged 5 to 12 years involve a belt or paddle. In addition, 23 states today allow school officials, including teachers, to paddle or otherwise physically discipline students.

Thus in America, corporal punishment is the rule rather than the exception, which is why many parents and educators get annoyed when it's criticized. Parents resent when pointy-headed academics tell them how to raise kids. And they don't buy that occasional spanking is harmful; after all, most parents themselves were hit as children and turned out fine.

I'm an example. As a child I was often slapped (once an imprint of my mother's hand adorned my face) and occasionally hit with a flatbread rolling pin, but became an arguably well-adjusted adult. However, this doesn't prove much -- the truth is that most smokers don't get lung cancer, most people having unsafe sex don't get AIDS, and most people playing Russian roulette once won't kill themselves. These are clearly high-risk behaviors -- and no one can predict in advance exactly who suffers later.

Numerous observational studies show that spanking, like smoking, subtly increases risks. According to Family Research Laboratory psychologist Murray Straus's studies of almost 8,000 families, spanking may increase aggression in adults two- to six-fold. Though it seems unbelievable, Straus found that men hit just once as teens were twice as likely to hit their own spouses.

A 1999 Canadian study of almost 5,000 adults found that spanking in childhood increased risk of depression, anxiety, and antisocial behavior in adults. Five separate long-term studies published between 1997 and 1999 support these trends; none reliably refutes them. Also, school-based corporal punishment may have racial and class bias. According to Temple University's Irwin Hyman, teachers hit minority and poor students four times more often than they hit middle-class whites.

Most parents and teachers believe spanking is more effective and immediate than reasoning with a child.

But no reliable study has shown corporal punishment superior to verbal reasoning and time-outs in promoting good behavior, and some data show it is less beneficial. The more 3- to 6-year-olds were hit in one study, published in Pediatrics in 1996, the worse their behavior after two years.

According to the pediatrics academy, consistently applied ''time-outs" rather than spanking improve ''compliance with parental expectations" by up to 80 percent. Another 1996 Pediatrics article found parents are open to other forms of punishment: 85 percent of mothers felt ''anger, remorse, and agitation" while hitting, and said they wouldn't spank if given effective alternatives.

Though anti-spanking advocates traditionally look to pediatricians to teach these techniques to parents, the average office visit is too short to be effective. More creative approaches are needed.

Extended group visits instead of short individual ones might allow pediatricians more time to discuss well-child care. Prenatal education could be expanded. While many expectant parents take birthing classes, few learn child-rearing skills. (Potential textbooks could include Thomas Phelan's ''1-2-3 Magic" and Jane Nelson's ''Positive Discipline" series.)

Some advocates think corporal punishment should be declared illegal, as it has been in 12 countries. According to the British Medical Journal, a 1979 Swedish ban on spanking coincided with a dramatic decline in acceptance of spanking among parents, from 53 percent to 11 percent. From 1979 to 1996, the country recorded only a single death from parent-child abuse. Still, it's unlikely spanking soon will become illegal on this side of the Atlantic.

Last year, the Supreme Court of Canada upheld a law decreeing that ''any person standing in the place of a parent is justified in using force by way of correction," if the force is ''reasonable." Similarly, many American states allow ''reasonable" discipline that doesn't cause bruising, bleeding, or fractures, while others such as Virginia would prosecute people who hot-sauce kids.

This legal confusion arises from a moral inconsistency. Why, for example, should husbands not beat their wives, but hit their children with impunity? Children's civil rights are no different than anyone else's. I'm all for parental authority, to be sure. But we should ultimately teach that the most powerful authority stems from the power of one's heart and mind, rather than the size of one's biceps.

Dr. Darshak Sanghavi is a clinical fellow at Children's Hospital and Harvard Medical School. His email address is sanghavi@post.harvard.edu. 

Copyright 2004 The New York Times Company